Officials at Howard County General Hospital insist that the facility can maintain its autonomy as a member of a new network of nine hospitals around the state, including the giant Johns Hopkins Hospital in Baltimore.
In fact, the Atlantic Health alliance announced two weeks ago should help make the hospital even more competitive, says Howard County General president Victor A. Broccolino, allowing it to share services and avoid duplicating programs.
"No hospital, no matter how big, can compete in the marketplace by itself," Mr. Broccolino said. "It needs affiliates. It needs collaborators."
Toward that end, the 233-bed Howard County General in Columbia will rely on the alliance and agreements with other hospitals and organizations to expand several of its services.
Among them are its pediatric and prenatal care units, cardiac capabilities and cancer surgery facilities.
And the hospital is developing plans with the University of Maryland Medical Center to open a rehabilitation center in Columbia that will include occupational, physical and speech therapy for adults and children.
Details of the rehabilitation unit still are being worked out, but after seven years of discussions the two institutions recently reached a "conceptual agreement" to open such a center, Mr. Broccolino said.
It comes after a separate agreement last fall between the hospital and the University of Maryland Medical Center to create a regional oncology center at the hospital.
"We're looking for as many ways as we can to expand our presence in the community," Mr. Broccolino said. "We have to do this to remain competitive."
University of Maryland officials echo the importance of such agreements.
Don Joyce, vice president of Kernan and Montebello hospitals and Post Acute Services, which are affiliated with the university medical center, said in a prepared statement that the partnership is "an excellent opportunity to provide valuable rehabilitation services to the residents of Howard County."
The Maryland Hospital Association says partnerships and mergers are necessary for community hospitals, particularly .
because health insurers are directing patients to less-expensive hospitals and outpatient service facilities.
The impact of such moves already has been felt at Howard
County General. Although the hospital's profits were up in the past fiscal year, its occupancy rate fell from 81 percent in 1990 to 57 percent during the first nine months of the fiscal year that ended Friday.
In the wake of similar pressures, nearly all major hospitals in the Baltimore area have formed alliances or merged over the past two years, seeking more bargaining power and economies of scale.
The Atlantic Health alliance includes Howard County General and eight others -- Johns Hopkins Hospital, Hopkins' Bayview Medical Center, Sinai Hospital, St. Joseph Medical Center, North Arundel Hospital, Carroll County General Hospital and Upper Chesapeake Health System in Harford County. The latter consists of Fallston General and Harford Memorial hospitals. By joining forces with the others, Mr. Broccolino said, Howard County General gains a wide variety of services without losing its independence or its ability to tailor its programs to the Howard County community.
"The alliance's structure does not inhibit the hospital, not at all," he said. "That's not to say the hospital can remain independent forever. The alliance might evolve into something stronger, but that's not the vision of the alliance."
Dr. Joyce Boyd, the Howard County health officer, agreed the alliance may help the hospital to deliver more services at a lower cost.
"I think [the alliance] will be positive for the county," she said. "I believe it will allow the county to continue its community focus."